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Guillain-Barré syndrome — RACP Paediatrics MCQ

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HardNeurology and neurodevelopmentGuillain-Barré syndromeRACP Paediatrics

A 9-year-old develops ascending leg weakness one week after diarrhoea. Examination shows areflexia, mild facial weakness and reduced vital capacity; sensation is mildly reduced. What is the most appropriate management?

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Correct answer: C — Admit for respiratory monitoring and intravenous immunoglobulin if progressing

Progressive weakness with areflexia after infection suggests Guillain-Barré syndrome; admission is needed for vital capacity/autonomic monitoring and IVIG is used for significant or progressive disease. CSF can be normal early and should not drive discharge when clinical risk is high. The pearl is that respiratory failure can develop despite relatively preserved limb power.

Reference: RCH Clinical Practice Guidelines: Guillain-Barré syndrome; Therapeutic Guidelines (eTG)